Article Data

  • Views 496
  • Dowloads 124

Original Research

Open Access

Middle latency auditory evoked potential index for prediction of post-resuscitation survival in elderly populations with out-of-hospital cardiac arrest

  • JUNYA TSURUKIRI1
  • KATSUHIRO NAGATA1
  • KENICHIRO KUMASAKA1
  • KEIKO UENO1
  • MASAHITO UENO1

1Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center

DOI: 10.22514/SV131.052017.26 Vol.13,Issue 1,March 2017 pp.80-83

Published: 20 March 2017

*Corresponding Author(s): JUNYA TSURUKIRI E-mail: junya99@tokyo-med.ac.jp

Abstract

Background. Out-of-hospital cardiac ar-rest (OHCA) is associated with a high mortality rate in the elderly. Although most reports have investigated among el-derly patients with OHCA until 1990s, non-invasive monitorings cannot pres-ently predicted cerebral resuscitation dur-ing cardiopulmonary resuscitation (CPR). Findings of a previous study suggest that monitoring of middle latency auditory evoked potentials (MLAEP) during CPR could provide an indicator of effective post-resuscitation survival.

Objectives. We speculated that the MLAEP index (MLAEPi), measured in an emer-gency room, can predict post-resuscita-tion survival among elderly patients with OHCA. 

Methods. This prospective study included 31 elderly patients aged ≥65 years with OHCA who received basic life support (BLS) and did not achieve restoration of spontaneous circulation (ROSC) until ar-rival at the emergency center between December 2010 and December 2011. All patients were administered advanced car-diac life support (ACLS) in the emergency room. Initial MLAEPi was measured using an MLAEP monitor (aepEX plus®, Audi-omex, UK) during the first cycle of ACLS. Prediction of the post-resuscitation sur-vival was investigated. 

Results. Eight patients who achieved ROSC were admitted to our hospital and 23 did not achieve ROSC in the emergency room. Initial MLAEPi was significantly higher in patients with than without ROSC (median, 33 vs. 26, p = 0.02). Three survivors, among patients with ROSC, were discharged from our hospital (survivors) and 5 died dur-ing hospitalization (non-survivors). Initial MLAEPi was significantly higher in sur-vivors than in non-survivors (median, 35 vs. 28, p = 0.03) or patients without ROSC (median, 35 vs. 26, p < 0.01). Conclusions. MLAEPi satisfactorily de-notes cerebral function and predicts post-resuscitation survival in elderly popula-tions.


Keywords

cardiopulmonary resuscitation, basic life support, advanced cardiac life sup-port, age, monitoring, critical care

Cite and Share

JUNYA TSURUKIRI,KATSUHIRO NAGATA,KENICHIRO KUMASAKA,KEIKO UENO,MASAHITO UENO. Middle latency auditory evoked potential index for prediction of post-resuscitation survival in elderly populations with out-of-hospital cardiac arrest. Signa Vitae. 2017. 13(1);80-83.

References

1. Akahane M, Tanabe S, Koike S, Ogawa T, Horiguchi H, Yasunaga H, et al. Elderly out-of-hospital cardiac arrest has worse outcomes with a family bystander than a non-family bystander. Int J Emerg Med 2012 Nov;5(1):41. doi: 10.1186/1865-1380-5-41.

2. Mosier J, Itty A, Sanders A, Mohler J, Wendel C, Poulsen J, et al. Cardiocerebral resuscitation is associated with improved survival and neurologic outcome from out-of-hospital cardiac arrest in elders. Acad Emerg Med 2010 Mar;17(3):269-75. doi: 10.1111/j.1553-2712.2010.00689.x.

3. Bonnin MJ, Pepe PE, Clark PS Jr. Survival in the elderly after out-of-hospital cardiac arrest. Crit Care Med 1993 Nov;21(11):1645-51.

4. Van Hoeyweghen RJ, Bossaert LL, Mullie A, Martens P, Delooz HH, Buylaert WA, et al. Survival after out-of-hospital cardiac arrest in elderly patients. Belgian Cerebral Resuscitation Study Group. Ann Emerg Med 1992 Oct;21(10):1179-84.

5. Tiainen M, Kovala TT, Takkunen OS, Roine RO. Somatosensory and brainstem auditory evoked potentials in cardiac arrest patients treated with hypothermia. Crit Care Med 2005 Aug;33(8):1736–40.

6. Sakurai A, Kinoshita K, Moriya T, Utagawa A, Ebihara T, Furukawa M, et al. Reduced effectiveness of hypothermia in patients lacking the wave V in auditory brainstem responses immediately following resuscitation from cardiac arrest. Resuscitation 2006 Jul;70(1):52-8.

7. Westerén-Punnonen SM, Yppärilä H, Musialowicz T, Korhonen I, Hynynen M, Partanen J. Recovery of N100 component of auditory event-related potentials and EEG after cardiac arrest during propofol sedation. Br J Anaesth 2005 May;94(5):626-9.

8. Reid KH, Mullins ER, Iyer VG. Changes in brainstem auditory evoked response latency predict survival after CPR in a rat model of cardiac arrest and resuscitation. Resuscitation 1998 Jan;36(1):65–70.

9. Takai N, oda S, Sadahiro T, Nakamura M, Watanabe E, Takeishi, et al. Auditory evoked potential P50 as a predictor of neurological outcome in resuscitated cardiac arrest patients. J Clin Neurophysiol 2011 Jun;28(3):302–7.

10. Jildenstål PK, Hallén JL, Rawal N, Gupta A, Berggren L. Effect of auditory evoked potential-guided anaesthesia on consumption of anaesthetics and early postoperative cognitive dysfunction: a randomized controlled trial. Eur J Anaesthesiol 2011 Mar;28(3):213–9. doi: 10.1097/EJA.0b013e3283400dbb9.

11. Mantzaridis H, Kenny GN. Auditory evoked potential index: a quantitative measure of changes in auditory evoked potentials during general anaesthesia. Anaesthesia 1997 Nov;52(11):1030-6.

12. Nolan JP, Deakin CD, Soar J, Böttiger BW, Smith G; European Resuscitation Council. European resuscitation council guidelines for resuscitation 2005. Section 4. Adult advanced life support. Resuscitation 2005 Dec;67 suppl 1:S39-86.

13. Ajam K, Gold LS, Beck SS, Damon S, Phelps R, Rea TD. Reliability of the cerebral performance category to classify neurological status among survivors of ventricular fibrillation arrest: a cohort study. Scand J Trauma Resusc Emerg Med 2011 Jun;19:38. doi: 10/1186/1757-7241-19-38.

14. Slabu L, Escera C, Grimm S, Costa-Faidella J. Early change detection in humans as revealed by auditory brainstem and middle-latency evoked potentials. Eur J Neurosci 2010 Sep;32(5):859–65. doi: 10.1111/j.1460-9568.2010.07324.x.

15. Doi M, Morita K, Mantzaridis H, Sato S, Kenny GN. Prediction of responses to various stimuli during sedation: a comparison of three EEG variables. Intensive Care Med 2005 Jan;31(1):41–7.

16. Doi M, Gajraj RJ, Mantzaridis H, Kenny GN. Relationship between calculated blood concentration of propofol and electrophysi-ological variables during emergence from anaesthesia: comparison of bispectral index, spectral edge frequency, median frequency and auditory evoked potential index. Br J Anaesth 1997 Feb;78(2):180–4.

17. Stoppe C, Peters D, Fahlenkamp AV, Cremer J, Rex S, Schälte G, et al. aepEX monitor for the measurement of hypnotic depth in patients undergoing balanced xenon anaesthesia. Br J Anaesth 2012 Jan;108(1):80-8. doi: 10.1093/bja/aer393.

18. Hayakawa K, Tasaki O, Hamasaki T, Sakai T, Nakagawa Y, Ogura H, et al. Prognostic indicators and outcome prediction model for patients with return of spontaneous circulation from cardiopulmonary arrest: the Utstein Osaka Project. Resuscitation 2011 Jul;82(7):874–80. doi: 10.1016/j/resuscitation.2011.02.045.

19. Marko N. Hypothermia during percutaneous coronary intervention in comatose survivors of cardiac care. SIGNA VITAE 2010;5 suppl 1:13-6.

20. Wampler DA, Collett L, Manifold CA, Velasquez C, McMullan JT. Cardiac arrest is rare without prehospital return of spontaneous circulation. Prehosp Emerg Care 2012 Oct-Dec;16(4):451–5. doi: 10.3109/10903127.2012.695435.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 0.5(2019) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top